Design: Systematic review and meta-analysis
Population: 160 studies, 16,639 parents of infants in NICUs
Primary outcome: Parental anxiety, depression, stress and trauma symptoms
Effect: Anxiety: psychotherapy g −1.66 (−1.97 to −1.34); family-centred care g −1.49 (−2.80 to −0.19); bonding g −0.90

This systematic review in JAMA Pediatrics included 160 studies of interventions to support parental mental health during a neonatal intensive care admission, covering 16,639 parents (94% mothers), with 85 estimates meta-analysed.

Parental anxiety fell with psychotherapy and emotional support (Hedges' g −1.66, 95% CI −1.97 to −1.34), family-centred care and education (g −1.49, −2.80 to −0.19) and bonding interventions such as skin-to-skin care (g −0.90, −1.50 to −0.30). Stress fell with psychotherapy, family-centred care and meditation-based approaches. Depression fell with psychotherapy and expressive therapies.

The authors recommend starting with interventions needing few resources, such as family-centred care and education, alongside psychotherapy where available. In Indian NICUs, where parents often have limited access, allowing parents in, teaching them to care for their baby and kangaroo care are low-cost first steps.

Screen NICU parents, especially mothers, for anxiety and depression during the admission.
Open the unit to parents and involve them in daily care as far as possible.
Encourage kangaroo (skin-to-skin) care; it supports both the baby and the parent.
Refer parents with significant symptoms for psychological support.

Why it matters

Parents' mental health during a NICU stay affects the infant's outcomes long after discharge.

The statistics, in plain English

Hedges' g is a standardised effect size: about 0.2 is small, 0.5 moderate and 0.8 or more large. Most effects here are large, but many studies were small and varied in design, so the true effects are probably smaller.